Expert Opinion on the Use of Vildagliptin in Indian Patients with Diabetes Mellitus

Abstract

Background: Diabetes mellitus is a prevalent disease, and its burden has increased over the years which is going to cross 134 million cases by 2045, despite the available treatments. This study was carried out to understand the prescribing behaviours in the management of diabetes. Methodology: In this cross-sectional study conducted from June 2022 to December 2022, a questionnaire was administered to clinicians focused on diabetes prevalence, symptoms, causes, clinical characteristics, and the utilization of different antidiabetic medications. The data collected was analysed using descriptive statistics. Results: Around 353 clinicians responded with the majority from Delhi (8.8%). The most commonly preferred first-line drug is metformin (46.5%). Vildagliptin (89%) is the most preferred drug out of the DPP-4 inhibitors that is added to metformin to achieve glycaemic control. Dapagliflozin (87%) is the most preferred SGLT-2 inhibitor. It was seen that 59.2% opted for DPP-4 inhibitor and SGLT-2 inhibitor FDC in 25 to 50% of their diabetic patients. If affordability was not an issue most clinicians (44.2%) preferred vildagliptin, dapagliflozin, and metformin FDC. Insulin usage declined with 38.8% reporting that they used insulin in only 11 to 15% of their diabetic patient pool and 71.4 % reported hypertension as the most common comorbidity with diabetes. Conclusion: This study gives a comprehensive view of the perspectives of the medical community with respect to evidence-based change in management trends which will help make strategies to improve patient outcomes. It also sheds light on factors clinicians consider to choose treatment options. One criterion that is as important as efficacy and safety is affordability.